The present invention relates to new methods, systems and devices for performing gynecological procedures.
There are many types of situations when it may be desirable to perform a medical procedure on a patient. The medical procedure may be diagnostic and/or therapeutic in nature. For example, one part of the human anatomy where medical procedures are commonly performed is the female reproductive system. The female reproductive system includes two main parts, the uterus and the ovaries. The uterus is a pear-shaped organ made up of two distinct anatomical regions: the cervix and the corpus. The cervix is a narrow cylindrical passage (about 1.5-4.0 mm in diameter) which connects at its lower end with the vagina. The corpus, which is the portion of the uterus that grows during pregnancy to carry a fetus, is shaped to include two portions: the lower uterine segment and the fundus. The cervix widens at its upper end to form the lower uterine segment of the corpus. The lower uterine segment, in turn, widens at its upper end into the fundus of the corpus. Dimensionally, the length of the uterus, measured from the cervix to the fundus, is approximately 8-10 cm, and the maximum width of the uterus, which is near the fundus, is about 4-5 cm. Extending from the fundus of the uterus on either side are fallopian tubes. The fallopian tubes are continuous with the uterine cavity and allow the passage of an egg from an ovary to the uterus where the egg may implant if fertilized.
One type of commonly-performed gynecological procedure (i.e., a procedure relating to the female reproductive system) is a sterilization procedure, i.e., a procedure intended to prevent future pregnancies. One of the more common types of sterilization procedures has been in the form of “tubal ligation,” which has been performed as follows: An appropriately-located incision is made in the patient's abdomen, and a laparoscope is inserted through the incision to provide access to a fallopian tube of the patient. A suture is inserted through the laparoscope and is tied around the fallopian tube in such a manner to cinch shut the fallopian tube, thereby preventing the fertilization of an egg within the tube. Because the inner surface of the fallopian tube is provided with a number of folds, several such sutures are typically used to cinch shut the fallopian tube at a plurality of spaced-apart locations. In addition, it is also common to sever the fallopian tube at a point between each pair of adjacent sutures as a further impediment to the fertilization of an egg. The above-described procedure is typically performed on both fallopian tubes.
One variant of the aforementioned “tubal ligation” procedure involves laparoscopically introducing a hook into the patient and using the hook to pull a portion of the fallopian tube into a hairpin loop. Then, a ligating band is inserted tightly around the looped portion of the tube so as to seal the tube shut. Another variant of “tubal ligation” involves laparoscopically introducing an electrocautery device into the patient and using the electrocautery device to sever the tube and to seal the tube shut.
Unlike the above-described sterilization procedures, all of which involve accessing the fallopian tubes laparoscopically and sealing the tubes shut by means located outside the fallopian tubes, certain recently-developed techniques involve accessing the fallopian tubes hysteroscopically and sealing the tubes shut by occluding the tubes from within. One such approach involves hysteroscopically placing within the fallopian tube a device comprising a self-expanding coil surrounding a fibrous polyester member. The fibrous polyester member induces scarring, i.e., the ingrowth of tissue into the fallopian tube, thereby resulting in occlusion of the fallopian tube. Examples of this type of “tubal occlusion” procedure are disclosed in U.S. Pat. No. 6,684,884, inventors Nikolchev et al., issued Feb. 3, 2004, and U.S. Pat. No. 6,705,323, inventors Nikolchev et al., issued Mar. 16, 2004, both of which are incorporated herein by reference. One modification of the aforementioned “tubal occlusion” procedure involves heating the implanted fibrous polyester member to induce further the ingrowth of tissue into the fallopian tube. An example of this modified procedure is disclosed in U.S. Pat. No. 6,726,682, inventors Harrington et al., issued Apr. 27, 2004, which is incorporated herein by reference.
In addition to the above-described sterilization procedures, many other types of gynecological procedures are commonly performed. Some of these procedures take place outside of the uterine cavity and include the draining of ovarian cysts, the treatment of endometriosis in the peritoneal cavity, and the removal of fibroids on the external surface of the uterus. At present, all of the foregoing types of procedures are typically performed using laparoscopic surgery. As can be appreciated, laparoscopic surgery requires suitable equipment and is typically performed in a hospital setting. As a result, such procedures often bear a large cost due to the setting and the support personnel required.